Nature and Science 2018;16(4) http://www.sciencepub.net/nature
Onchocerciasis: Perception and status of community members in non-ivermectin coverage areas of Ogun State, Nigeria.
1Sam-Wobo, Sammy Olufemi, 2Asimiea, Aminanyanaba Onai, 3Oganah, Beatrice Chi, 1Ebisanmi, Olureti, 1Oludemi, Abidemi Olufunmilola, 1Alade, Monsurat Olukemi., 1Oyetola, Olukem, 4Adeleke, Monsuru Alani and 1Surakat, Olabanji Ahmed
1Department of Pure & Applied Zoology, Federal University of Agriculture, Abeokuta; 2Department of Crop and Soil Science, Faculty of Agriculture, University of Port Harcourt 3Department of Home Economics, Adeniran Ogunsanya College of Education, Oto- Ijanikin, Lagos 4Department of Biological Sciences, Osun State University, Oshogbo, Nigeria. [email protected]
Abstract: With the global focus towards elimination of onchocerciasis especially in endemic countries like Nigeria, a study to determine the status of onchocerciasis and knowledge of people towards eliminating onchocerciasis was conducted in six riverine communities, namely Eyinwa, Aiyepe and Okun Owa in Odogbolu Local Government Area (LGA), and Akaka, Ilara and Orile-Oko in Remo Local Government Area of Ogun State, Nigeria. Utilizing the rapid epidemiological mapping for onchocerciasis (REMO) tool, 420 consented participants were physically examined for nodules and questionnaire administered to them to obtain information on knowledge and perception on the disease. Data obtained were analysed using SPSS version 16 into percentile and assessment of variables for significant relationships. The results showed a nodular rate of 17% and 30% in participants for the two LGAs. Most respondents (69%) and (87%) the two LGAs had knowledge of the disease. However, 50% respondents from Odogbolu, and 54% from Remo reported itching as the major symptom. Assessing the use of ivermection as drug to control the spread of the disease, 72% of respondents in Odogbolu and 49% in Remo North are of the opinion that ivermectin could reduce transmission, howbeit 26% and 23% believes that control could be possible through good hygiene. The need for Government and health agencies to embark on massive health education about the disease is advocated so as to eliminate the negative effect of the disease with infected individuals. [ Sam-Wobo, Sammy Olufemi, Asimiea, Aminanyanaba Onai, Oganah, Beatrice Chi, Ebisanmi, Olureti, Oludemi, Abidemi Olufunmilola, Alade, Monsurat Olukemi., Oyetola, Olukem, Adeleke, Monsuru Alani and Surakat, Olabanji Ahmed. Onchocerciasis: Perception and status of community members in non-ivermectin coverage areas of Ogun State, Nigeria. Nat Sci 2018;16(4):1-5]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj160418.01.
Keywords: Onchocerciasis, Perception, Ivermectin, Ogun State, Nigeria.
Introduction It is basically a rural and semi-urban disease Onchocerciasis, commonly called river often associated with long-term exposure to infection. blindness, is a parasitic disease of public health It affects communities along fast-flowing rivers importance in endemic parts of the world, especially causing desertification of arable farmland, low yield sub-Saharan, Africa where more than 90% of all cases in agricultural productivity and ultimately impacting occur (Adeleke et al., 2010). It is caused by nematode on the socio-economic development of people worms, Onchocerca volvulus which mates and concerned (Edungbola and Asaolu, 1984, Abiose, produce tiny juvenile worms that migrate throughout 1998; WHO, 1995). the skin and eyes, causing the various symptoms of Nigeria has been reported to have the highest the disease (Opoku 2000, Sam-Wobo et al., 2012). incidence of onchoceriasis infection accounting for The disease is transmitted by a hematophagous about 40% reported cases globally (Anosike et al., vector called black fly of the genus Simulium (Benton 1994, WHO 1995; Opara et al., 2008, Ojurongbe et et al., 2002). This fly breeds in rapidly flowing al., 2015). Distribution of the disease in Nigeria cuts streams and rivers, and thus the name river blindness. across communities with precambrian rocks The most severe consequences of onchocerciasis is embedded in their river systems. With the long flight blindness, severe itching, impaired vision, physical range of the vector ranging between 56km-79km scars from constant scratching, depigmentation and (Thompson 1976), and human migration factor thickening of the skin (WHO 1995). favoring the spread of infectious diseases (Nwoke
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2015, Surakat et al, 2016); there is the possibility that disease onchocerciasis. The questionnaire was some communities previously mapped holo-endemic designed to provide demographic information such as may be harboring the disease. In considering the name of village, type of administrative level, name of onchocerciasis elimination effort by World Health nearest river, community participation under CDTI, Organization, it is important to reaffirm disease status name of first and second administrative level, and assess the knowledge, and perception of educational institutions available (if any), health community members in non-ivermectin treatment institutions and geographical coordinates of the areas with a view to providing information for further village, as well as the knowledge and opinions of intervention measures by health intervention agencies. respondents about river blindness and its transmission. This study reports the status of onchocerciasis using the REMO tool, and perception of community Physical examination members to the disease in Odogbolu and Remo North Using REMO tool for nodule assessment, both Local Government Areas of Ogun State. men and women who were enlisted, and had resided in the community for at least 10 years participated in Materials And Methods the physical examination. Participants were examined Study area for nodules and all other clinical manifestation of The study was conducted in six riverine onchocerciasis. communities, namely Eyinwa (latitude 06.7500556, longitude), Aiyepe (latitude 06.8339980, longitude Data analysis 03.7534476) and Okun Owa (latitude 06. 8606899, The questionnaires and nodule data were longitude 03. 8319992) communities in Odogbolu analyzed using SPSS version 16.0 and the results LGA, and Akaka (latitude 06.9642843, longitude expressed in percentages and assessment of variables 03.7212467), Ilara (latitude 06.9317909, longitude for significant relationships. Using a Global 03.7269992) and Orile-Oko (latitude 07.0680899, Positioning System (GPS) hand-held device, longitude 03.7817525) communities in Remo North geographic coordinates were obtained for each LGA of Ogun State. community.
Ethical clearance Results Approval was sought and obtained from the Demographic characteristics of the respondent in ethical review committee of Odobgolu and Remo Odogbolu and Remo North LGA. North local government. Written permission was Analysing demographic characteristics, the study obtained from the traditional rulers of each observed that males were 96(46%) and 114 (54%) community for easy access and community females for Odogbolu, while in Remo North, 89(42%) mobilization. Informed consent was also obtained were males and 121(58%) were females, but not from the individuals that participated in the study. All statistically significant (p>0.05). On the age range of participants positive for nodules were treated with respondents, the values are varied (table 1), with a ivermectin at the end of the study. significant difference between the age ranges (p<0.05). On the level of education, respondents with Selection of communities secondary school education 74 (35.2%) and 71 (34%) The six communities located in non-intervention respectively were more than other levels of education areas for Mass Drug Administration MDA were in both LGAs, while farmers and artisans were more selected using a systematic grid sampling techniques than other occupational status (table 1). for both LGAs. Using the primary health care house numbering, 70 respondents were randomly selected Nodules palpation among respondents from each community and enlisted, and only The results are presented in table 3. From the participants 5 years and above participated. equal number of 210 participants who were examined for nodules in Odogbolu and Remo North Questionnaire design respectively, 35 (17%) were positive in Ogogbolu and Structured questionnaire were used to obtain 63 (30%) positive in Remo North. There were no information on knowledge and the perception of reported cases of blindness. community members on the transmission of the
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Table 1: Demographic Characteristics of the Respondents. Odogbolu LGA Remo LGA Parameter No. of Respondents % Frequency % Sex Male 96 46 89 42 Female 114 54 121 58 Age 11 – 15 13 6.2 20 10 16 – 20 9 4.3 2 12 21 – 25 11 5.2 17 8 26 – 30 24 11.4 34 16 31 – 35 27 13 35 17 36 – 40 29 14 67 32 Above 40 97 46.2 10 5 Education Primary 60 29 43 21 Secondary 74 35.2 71 34 No Formal Education 46 30 53 25 Occupation Farmer 70 33.3 35 17 Trader 48 23 36 17 Student 25 12 355 17 Government Employee 12 6 54 26 Artisan 55 26.2 50 24
Table 2: Community member’s knowledge on onchocerciasis in Odogbolu and Remo North LGAs Parameter Odogbolu LGA Remo North LGA Have you heard about the disease River Blindness? Frequency % Frequency % Yes 145 69 183 87 No 65 31 27 13 Total 210 100 210 100 What do you think causes the disease onchocerciasis Bad Blood 32 15.2 13 6.2 Body Bleaching 1 0.5 1 0.5 Insect 24 11.4 46 22 Through Food 58 26 56 27 Farm Work 5 2.4 27 13 No Idea 90 44 48 23 How is the parasite transmitted Through blackfly bite 62 30 127 61 Through insect bite 20 10 36 17.1 Uhygienic environment 128 61 47 22.4 What are the symptoms of infection with the parasite Itching 104 50 113 54 Visual Impairment 75 36 9 4.3 Rashes 11 5.2 6 3 Weakness 18 9 9 4.3 No Idea 2 1.0 41 20 Nodules 8 4 Blisters on body parts 24 11.4 How do you think the disease can be prevented Hygiene 54 26 49 23 Use of ivermectin 152 72 102 49 Stay away from fast flowing river 4 2 59 28
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Table 3: Physical Examination of Household for Nodules and Observations LGA No. Examined for Nodules No. Positive Cases of Blindness Odogbolu 210 35 (17) Nil Remo 210 63 (30) Nil
Discussion and interventions strategies in order to maintain the This study presents investigation on community progress made in its current control effort. members’ knowledge of onchocerciasis in non- intervention areas, considering also that intervention Conclusion through the distribution of ivermectin in identified Large scale nodulectomy, skin biopsy and use of communities have been ongoing since 2002 in Ogun newly developed diagnostic tool such as the Ov16 State. Since the disease cuts across age, sex and rapid assays are recommended to properly situate the educational levels, it is important for community results of nodule prevalence observed in the study. members to have a knowledge of the disease and the Also, health agencies are advised to do more in areas observed responses indicate that 69% and 87% of public enlightenment on the biology and life cycle respondents are knowledgeable about the disease in of the parasites involve. Odogbolu and Remo North LGAs respectively. There were varied responses to the cause of the References disease, however it is important to note that 43% of 1. Abiose, A. (1998). Onchocercal Eye Disease and respondents in Odogbolu and 23% in Remo North had the impact of Mectizan. Annals of Tropical no inclination to the cause of the disease; in which Medicine and Parasitology, 92 Suppl 1: S11 – some respondents had the opinion that choice of diet S22. could be a predisposing factor to the disease. Body 2. Adeleke MA, Mafiana CF, Sam-Wobo SO, bleaching, farm work, bad blood and insects bites Olatunde GO, Ekpo UF, Akinwale OP, Toe L. were implicated in the study as the causes of (2010). Biting behaviour of Simulium damnosum onchocerciasis. The reasons could be attributed to the complex and Onchocerca volvulusinfection dermatological effects of Simulium bites. This may be along Osun River, Southwest Nigeria. Parasit so as majority of participants agree that severe itching Vector 3(93): 1–5. and skin rashes are symptoms of infection which also 3. Anosike, J.C, and Onwuluri, C.O.E. (1994). supports comments from previous studies (WHO Studies on filariasis in Bauchi State Nigeria. 1 1997). Endemicity of human Onchocerciasis in Ningi Furthermore, the general opinion that black fly local government area. Annals of Tropical bite is responsible for parasite transmission could be Medicine and Parasitology, 89 (2): 31-38. attributed to the appreciable secondary level of 4. Benton, B., Bump, J., Seketeli, A., Liese, B. education of most respondents. A considerable (2002). Partnership and Promise. Evolution of amount of respondents believe that maintaining an the African River-Blindness campaigns. Annals unhygienic environment is a supporting factor in the of Tropical Medicine and parasitology; 96: 5-14. distribution of the disease while some recognized that 5. Edungbola, L.D, and Asaolu, (1984). staying away from fast flowing rivers and use of Parasitologic survey of onchocerciasis (river ivermectin are ways of preventing the disease. blindness) in Babana district, Kwara State, The study further revealed a nodule prevalence Nigeria. American Journal of Tropical Medicine level of 17% and 30% in community members of and Hygiene, 33: 1149-1154. Odogbolu and Remo North LGA, but with no 6. Nwoke B.E.B (2015) The challenges of human recorded case of blindness. Presence of nodules are migration in onchocerciasis elimination in not totally suggestive of onchocerciasis, a Africa. Nigerian Journal of Parasitology, 36: 4- confirmatory diagnosis is required. 9. Since CDTI intervention is not applicable to 7. Ojurongbe O, Akindele AA, Adeleke MA, areas with prevalence less than 20% (WHO, 1993). Oyedeji MO, Adedokun SA, et al. (2015) Co- Treatment of onchocerciasis in areas mapped hypo- endemicity of Loiasis and Onchocerciasis in endemic are carried out in the clinics, rather mass Rain Forest Communities in Southwestern administration of drugs in communities. Hence, Nigeria. PLoS Negected Trop Dis 9(3): achieving elimination of the disease in Ogun State e0003633. doi:10.1371/journal.pntd.0003633. will involve strategic adjustments to the mix of tools 8. Opara K. N., Usip L. P. and Akpabio E. E. (2008) Transmission dynamics of Simulium
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